Application of Internet nursing based on transtheoretical model in diet management of patients with chronic kidney disease / 中国实用护理杂志

ABSTRACT

Objective:To explore the effect of Internet nursing based on transtheoretical model (TTM) in dietary management of patients with chronic kidney disease (CKD).Methods:A total of 160 CKD patients in the Nephrology Clinic of Tianjin First Central Hospital were selected and divided into the control group and the observation group by convenience sampling and simple randomization, with 80 cases in each group. Quantitative diet management were given in the control group and Internet nursing intervention with TTM as the framework in the observation group for 6 months. The distribution of behavioral stages, dietary compliance and changes in clinical laboratory parameters before and after intervention were investigated in the two groups.Results:After intervention for 3 and 6 months, the distribution of behavioral phase in the observation group was better than that in the control group, and the difference was statistical significant ( χ2=28.48, 48.49, all P<0.01); the daily sodium intake in the observation group was (2.86 ± 0.64), (2.58 ± 0.56) g, and the daily protein intake was (0.81 ± 0.18), (0.76 ± 0.13) g/kg, respectively; the daily sodium intake and daily protein intake in the control group were (3.76 ± 1.42), (4.11 ± 1.49) g and (1.00 ± 0.19), (1.04 ± 0.21) g/kg, respectively, and the differences between the two groups had statistical significance ( t values were 26.74 -105.11, all P<0.01). After intervention for 3 and 6 months, systolic blood pressure was (126.41 ± 9.12) and (124.96 ± 8.58) mmHg (1 mmHg=0.133 kPa), serum creatinine was (177.01 ± 89.04) and (183.24 ± 101.48) μmol/L in the observation group, while systolic blood pressure was (133.16 ± 14.28) and (133.18 ± 12.34) mmHg, serum creatinine was (213.29 ± 108.02) and (222.61 ± 117.33) μmol/L in the control group, and serum potassium and serum phosphorus were (4.37 ± 0.38) and (1.10 ± 0.16) mmol/L after intervention for 6 months in the observation group, while (4.60 ± 0.43) and (1.21 ± 0.21) mmol/L in control group, and the differences between the two groups had statistical significances ( t values were 5.16-23.89, all P<0.01). Using repeated measures analysis of variance, there were significant differences in daily sodium and protein intake, time effect, effect and interaction effect of systolic blood pressure, serum creatinine, serum potassium and serum phosphorus ( Ftime values were 8.97-61.66, Finterblock values were 3.96-32.28, Finteraction values were 3.15- 36.35, all P<0.05), diastolic blood pressure time effect and interaction effect ( Ftime=8.08, Finteraction=3.64, all P<0.05), and blood uric acid time effect ( Ftime=10.50, P<0.01). Conclusions:The Internet care model framed by TTM is beneficial for improving dietary behavior, improving dietary compliance, and improving clinical laboratory parameters in CKD patients in the long term.